Implementing the Orebro Musculoskeletal Pain Screening Questionnaire in Clinical Practice
By Luke McManus | 20th June 2019 | Clinical Development
This is a follow-up article to a recent publication in the Australian Physiotherapy Association (APA) magazine ‘InMotion’ in May 2019.
This APA article summarised the results of how educating for and implementing the Orebro Musculoskeletal Pain Screening Questionnaire (OMPSQ-10) contributed to significant behaviour change in the use of this screening tool in a metropolitan physiotherapy private practice setting.
A summary of organisational factors:
- The OMPSQ-10 can be accessed here
- A digital version of the OMPSQ-10 can be found on the painHEALTH website here (2)
- It’s helpful to include the OMPSQ-10 as part of the initial paperwork for patients on their first physiotherapy consultation
- The patient doesn’t need to add up their score, as this can reduce accidental errors as some questions are scored as ‘10 minus the score reported’
Interpreting the OMPSQ-10 score
As mentioned in Linton et al (2011) article on the development of the OMPSQ-10, scores greater than 50/100 are considered high risk in terms of prediction of chronicity and longer term work absence(1).
The ten questions are also five broad categories, which are (1):
- Pain - questions one and two
- Self-perceived function - questions three and four
- Distress - questions five and six
- Return to work expectancy - questions seven and eight
- Fear avoidance behaviour - questions nine and ten
These five categories can also be monitored over time with repeat OMPSQ-10 assessments, to monitor any change in these areas in conjunction with the total score.
Usefulness in clinical practice
The OMPSQ-10 is a useful questionnaire to objectively measure a patient’s risk of longer work absence and chronicity.
In my experience, the OMPSQ-10 has been helpful in outlining topics that can be discussed further in the subjective examination.
For example, if a patient is scoring high on questions regarding distress (anxiety and depression), we can gently ask if they would like to discuss this any further?
Sometimes patients can experience an increase in anxiety that is associated with not understanding their recent musculoskeletal pain, and simply discussing their diagnosis and management options, can feel empowered and fairly quickly less distressed.
For patients who have experienced more long-standing distress, physiotherapists can still provide a safe space for the patient to discuss anything they feel comfortable with and can help them look into available options for more skilled assessment and help with their distress. This could be chatting to their GP and discussing if any formal counselling or psychological help might be helpful.
The OMPSQ-10 can also be a helpful way of identifying possible concurrent sleep disturbances. This role of sleep in effective recovery from musculoskeletal pain is probably best kept for another time, but this could at least serve as a starting point to ask the patient about their sleep hygiene and educate them of the importance of good sleep habits.
The OMPSQ-10 also looks with questions nine and ten, into fear-avoidance behaviours. It is known that fear can contribute to movement behaviours that are may not be helping the patient in their recovery.
Education to help encourage confidence in the patient’s capacity and movement behaviour can be very helpful, and the OMPSQ-10 can often be one way of first approaching this subject.
Having used the OMPSQ-10 as part of our initial paperwork for quite a while now, it feels a natural part of the initial assessment and subsequent reassessments over the course of treatment for most patients.
Screening tools are certainly not perfect, but they can be really helpful as a part of a broader clinical examination for physiotherapists.
- Linton SJ, Nicholas M, MacDonald S. Development of a short form of the Orebro Musculoskeletal Pain Screening Questionnaire. Spine. 2011;36(22):1891–1895.
- PainHealth website
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